It's easy to get answers about health and nutrition! Just send your question by email to firstname.lastname@example.org and Dr. Harlan will respond to selected questions of general interest. Answers will be posted in the Ask Dr. Gourmet newsletter (sign up now!) and archived in the Ask Dr. Gourmet section of the website.
From Aug to March of last year I lost 65 pounds on the Medifast diet which is typically less than 1000 calories per day. You eat five of their mini-meals per day plus one "lean & green" meal consisting of meat and vegetables. I like it because it seems like I'm getting away from food altogether, much like a person with an addiction to cigarettes or alcohol needs to get away from their addictions altogether. And I've felt really well while following it.
But recently, due to various usual work frustrations, holidays, etc. my weight has crept back up about 5-8 pounds. I want to shed this weight plus a little extra to make sure I'm well into my healthy BMI range. I suspect that my metabolism is pretty low from following that diet for so long, and it seems like the only way to lose this excess is to go back on Medifast, due to my body being used to so few calories.
I've done this (Medifast) without much success so far for the past month or two. But I'm tired of it! Many calorie estimators say that at my age and weight I should consume 1500 calories per day, but it seems like if I consume 1500 calories per day, I'll either not lose any weight or maybe even start gaining! I feel like I've shot myself in the foot. Am I stuck with restricting my calorie intake to less than 1000/day?
Congratulations on your weight loss! It's great that you feel better.
While I am not a fan of diets like Medifast, it does work for some folks. With such diets, people do see that issue of slowed metabolism when being on so few calories. Another concern of mine is that the programs seldom spend enough time teaching folks how to transition back to healthy eating. Consequently, there is often a creeping weight gain once you end the diet.
A planner that chooses a calorie target based on your height, weight, and age is not a doctor or dietitian sitting in a room with you discussing all of the factors that go into the amount of calories you eat vs. exercise, your likes and dislikes, your precise Body Mass Index, Waist to Hip Ratio, etc.. It may be that you will do better at 1,200 or 1,000 calories for a short period of time while you lose the 5 - 8 lbs. and get to your target and that the 1,500 calories is a good target for you to maintain your weight.
Keep in mind that weight loss will always be slower eating real food vs. diets like Medifast. This is OK and target weight loss for most folks should not be more than about one pound per week. That's frustrating for a lot of people who are used to silly ads that scream at them, "I lost 10 pounds in 10 days." What those ads and the diets they are selling don't say is that a month later people gain back 12 pounds: 2 more than they lost.
Check with your doctor about a good calorie intake target. He or she can give you a good idea of which calorie target is going to work best for you. If your doctor is not knowledgeable in this area, you may find it helpful to consult with a dietitian - your physician can give you a referral. My belief is that by eating real food and good quality calories that are satisfying, you'll learn to eat well and keep the weight off.
Thanks for writing,
Timothy S. Harlan, MD, FACP, CCMS